Hospital Activity Based Costing

Activities Admission T1 Admission T2 Oxygen T1 Oxygen T2 Patient T1 observations Patient T2 observations Patient T1 shifting Patient T2 shfting Patient T1 food Patient T2 food Patient T1 cleaning Patient T2 cleaning Doctor visit T1 Doctor visit T2 Specialist visit T1 Specialist visit T2 T1 Administer medicines T2 Administer medicines Room service Documenttation T1 Documenttation T2 Discharge

Oxygen Unit -> ltr Activity Cost Driver Rate (Rs) -> 200 No. of admissions No. of admissions Oxygen ltrs Oxygen ltrs Stay days Stay days No. of investiations (1) No. of investiations (2) Stay days Stay days Stay days Stay days Stay days Stay days Stay days Stay days Stay days Stay days Stay days Stay days Stay days Num

4 10

Doctor Gen Doctor Doctor Nurse Catering Nurses Medicine Specialist Intern Intern day hr hr hr hr hr 400 300 1000 1500 500 100 1 2

2 4 1 2 0.5 2 1 1

1 1

1

1 2

2 3

1

1 2

0.5 1

0.5 1 0.1 0.5

0.5 1

1 2

Patient House Air Temp, Support Staff Keeping Clerical Billing Hum, ppm Overall hr hr hr bill day Rate 100 100 200 1000 700 1 2

1 1

0.2 0.2

1 2 0.5 0.5 1 1 0.5 0.5

1

1 0.5 0.5 1

2

2040 4440 800 2000 600 1200 3000 6500 200 650 400 400 800 1550 150 750 150 300 800 100 100 2200

T1 T2 Patient Patient day day 11240 20890 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

1 1 1 1

Infrastructure Costs are Extra

1

Activities Admission Oxygen Patient observations Patient shifting Patient food Patient cleaning Doctor visit Specialist visit Administer medicines Room service Documenttation Transfer

Oxygen Unit -> ltr Activity Cost Driver Rate (Rs) -> 200 No. of admissions Oxygen ltrs Stay days No. of investiations (1) Stay days Stay days Stay days Stay days Stay days Stay days Stay days Num

10

Doctor Gen Doctor Doctor Nurse Catering Nurses Medicine Specialist Intern Intern day hr hr hr hr hr 400 300 1000 1500 500 100 1 8 1 3 3

1

1

1

2

1

1

2

2 1

4

Patient House Air Temp, Support Staff Keeping Clerical Billing Hum, ppm hr hr hr bill day Overall 100 100 200 1000 700 Rate 1

1

0.2

1 1 2

1

1 1 1

2

1

2140 2000 2400 3000 1000 1100 3000 1500 1200 800 200 2200

1 1 1 1 1 1 1 1 1 1 1 1

Infrastructure Costs Extra

ICU Patient Rate day 20540

Unit Area Special Bed Oxygen Infrastructure ECG Status & Other Monitor

Rate

Sq ft day 10 Num day 200 Num day 50 Num day 100 Num day 3000 Infrastructure Costs Running Costs T1 Running Costs T2

Ward 150 1 1 0 0 1750 11240 20890

ICU 40 1 1 1 1 3750

Total Coosts T1 12990 Total Coosts T2 22640 Running ICU Costs

20540

Total ICU Costs

24290

Unit Area Eqpt Duration Eqpt Infrastructure Electricity Support Staff Nursing Staff Analysis Report

Sq ft hr hr Num hr hr hr Num Num

Rate CT Scan OT 10 10000 1000 700 200 300 2000 1000

Units & Costs CT Scan

10 10000 1000 800 200 300 0 1000

800 2 1 2 4 1 1 1

Total Infrastructure Costs

34500

Units & Costs OT 1000 4 1 4 4 8 0 1

58400

Activity Cost Pools Physician Activity Pool Nurse Practitioner Activity Pool Total Base Salary 603922 Base Salary Transfer from clinical Pool 209438 Transfer from clinical pool Transfer from physician pool Transfer to NP Pool (2) -10784 Transfer to I/R Pool (3) -107843 Total 694733 Total Activity Cost Matrix

r Activity Pool Clinical Activity Pool Total Total 53258 Base Salary 313481 2194 Transfer to NP Pool (4) -2194 10784 Transfer to Physician Pool (5) -209438 Transfer to I/R Pool (6) -99654 66236

Total

2195

Intern / Resident Activity Pool Clerical Activity Pool Total Total Base Salary 282888 Base Salary 211620 Transfer from Clinical Pool 99054 Transfer from Supplies 20246 Transfer from Physician Pool 107843

Total

489785

Total

231866

Activities

Admission T1 Admission T2 Oxygen T1 Oxygen T2 Patient T1 observations Patient T2 observations Patient T1 shifting Patient T2 shfting Patient T1 food Patient T2 food Patient T1 cleaning Patient T2 cleaning Doctor visit T1 Doctor visit T2 Specialist visit T1 Specialist visit T2 T1 Administer medicines T2 Administer medicines Room service Documenttation T1 Documenttation T2 Discharge

Activity Cost Driver

No. of admissions No. of admissions Oxygen ltrs Oxygen ltrs Stay days Stay days No. of investiations (1) No. of investiations (2) Stay days Stay days Stay days Stay days Stay days Stay days Stay days Stay days Stay days Stay days Stay days Stay days Stay days Num

Oxygen Unit -> ltr Rate (Rs) -> 200 4 10

Doctor Gen Doctor Doctor Nurse Catering Nurses Medicine Specialist Intern Intern day hr hr hr hr hr 400 300 1000 1500 500 100 1 2

2 4 1 2 0.5 2 1 1

1 1

2 3

1

1 2

1

1 2

0.5 1

0.5 1 0.1 0.5

0.5 1

1 2

Patient House Air Temp, Overall Support Staff Keeping Clerical Billing Hum, ppm Rate hr hr hr bill day 100 100 200 1000 700 1 2

1 1

0.2 0.2

1 2 0.5 0.5 1 1 0.5 0.5

1

1 0.5 0.5 1

2

2040 4440 800 2000 600 1200 3000 6500 200 650 400 400 800 1550 150 750 150 300 800 100 100 2200

In fr a st ru ct ur e C o st s ar e E xt ra

T1 T2 Patient Patient day day 11240 20890 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1

1 1 1 1

Ward Infrastructure Costs Running Costs T1 Running Costs T2

1750 11240 20890

ICU 3750

Total Coosts T1 12990 Total Coosts T2 22640 Running ICU Costs

20540

Total ICU Costs

24290

Activity Cst Pools . Resource Cost Pools Physician Salary NP Salary Nurses Salary I/R Salary Clerical Salary Supply Billing Subtotal

Total Costs 603922 53258 313481 282888 211620 20246 25490 1510905

Activity Cost Matrix Physician NP Visits Nurses I/R Visits Visits Visits 451494 209438

27685 53258 2194

124743 2195

99654 282888

660932

83137

2195

507285

rix Clerical Support

198055 18948 217003

Clerical New Patient

Billing

13565 1298 14863

25490 25490

Total

603922 53258 313481 282888 211620 20246 25490 1510905

Visit A Stanard Time Spent (Min/Visit) Mini Visits Short Visits Routine Visits Extended Visits Complex Visits Comprehensive Visits Employee Visits

Physician Physician NP Patient Visits Visits / / Yr Mins/ Yr Yr 5 43 215 68 10 186 1860 328 22.5 7469 168052.5 237 37.5 2437 91387.5 13 60 64 3840 60 15 900 45 0 10214 266255 646

Visit Analysis NP Patient I/R Visits / NP Employee NP Employee Nurse Nurse Visists / Yr Visits / Yr mins/yr Visists / Yr mins / yr Yr 340 101 505 445 2225 63 3280 281 2810 83 830 323 5332.5 5 112.5 81 1822.5 2440 487.5 0 0 354 0 0 0 29 0 0 0 31 0 332 14940 0 9440 719 18367.5 609 4877.5 3240

Total I/R Visists / mins / yr Yr 630 720 6460 1201 109800 10232 26550 2804 3480 93 3720 46 0 332 150640

Activity Driver Assignment Activity Cost Pool Physician Time NP Time RN Patient Time I/R Time Clerical Support - Patient Visits Clerical Support - New Patient Visits Billing Total Activity Cost

Activity Driver Assignment Activity Driver Exam min spent with patient Exam min spent with patient Exam min spent with patient Exam min spent with patient Num of PCU Patient visits Num of PCU Patient visits Num of PCU Patient visits

Num of Activity Cost Driver Units 930108 94317 7458 622704 217003 14863 25490 1911943

266255 27808 4878 150640 15428 2115 15428

Activity Driver Map 3.49 3.39 1.53 4.13 14.07 7.03 1.65

Product Cost Matrix : Routine Visits Physician Visits Activity Driver Rate Units Physician Exam NP Exam Nurse Exam I / R Exam Clerical Support / visit Clerical New Patient Support / visit Billing / Visit Total Product Cost

3.49 3.39 1.53 4.13 14.07 7.03 1.65

22.5

1 1

tine Visits Physician Visits Costs 78.53 0 0 0 14.07 0 1.65 94.25

I /R Visits Units Costs

45 1 1

0 0 0 185.85 14.07 0 1.65 201.57